Get Fl American Heritage Life Insurance Company Abj16661 2017-2025

Filling out the FL American Heritage Life Insurance Company ABJ16661 form is crucial for managing direct deposit for claims payments. This guide provides a clear and step-by-step approach to ensure you complete the form accurately and efficiently.

Follow the steps to successfully complete the form.

1. Press the ‘Get Form’ button to access the form and open it in an available editing tool.
2. Begin by entering your policy or certificate holder information, including your full name, home phone number, policy certificate number(s), and social security number.
3. Select the type of transaction you want to initiate: new setup, cancellation, change financial institution, or change account number.
4. Specify your financial institution details. Indicate whether the account is a checking or savings account, and provide the name and address of the financial institution.
5. Enter your account number and the electronic routing transit number. Ensure you confirm this routing number with your bank, as some banks use a specific number for electronic deposits.
6. Attach either a voided check or a bank letter as specified. The voided check must have your pre-printed name and address, and it should include both the account and transit numbers. Alternatively, the bank letter must be on official bank letterhead and include your name, account number, and transit number.
7. Review the acceptable account holders and signatures section. Ensure that the person completing the form is listed as a policy/certificate holder, power of attorney, or beneficiary.
8. Carefully read the authorization and signature section before signing. Ensure that all information provided is accurate and complete.
9. Date the form after signing it to officially finalize your request.
10. Deliver the completed and signed form along with the voided check or bank letter either by faxing it to 1-866-424-8482 or mailing it to the Claims ACH Department at the specified address.

Complete your forms online today to ensure a smooth claims payment process.